Written by Dr. Goku, Psy. D, Guardians MH Clinical Director
Anxiety
We may not know how to define it, but we know how it feels
What is anxiety, or rather, what do you know about anxiety?
For many people, they find these questions hard as they can’t verbalize their understanding of the
concept, it’s much easier for them to elaborate on how anxiety makes them feel. For many of the
clients that I’ve seen, they often state feeling nervous, scared, tense or stressed. They also have
an easier time elaborating the physical symptoms and manifestations of anxiety rather than the
emotional ones (Bourne, 2015; South-West Yorkshire Mental Health; Gagnon. N.D.):
- Shortness of breath
- Heart palpitations
- Trembling or shaking
- Sweating
- Choking
- Nausea or abdominal distress
- Numbness
- Dizziness
- Feelings of detachment
- Hot flashes or chills
- Fear of dying
- Fear of going crazy
While these physical symptoms are unpleasant at the time, they are completely normal reactions,
all while not being dangerous.
But what is anxiety? How does it work?
Before defining anxiety, we must first understand what stress is. In its purest form, stress is your
brain reacting to a perceived threat and placing your body in a reactionary state. It is the product
of thousands of years of evolution and associations made by our brains. It can also be described
as our survival instinct and also is what keeps us from doing dangerous things, for example,
jumping out of a plane with no parachute. While stress is something that is normal and helps us
stay safe, stress becomes a problem when it’s disproportionate to the situation.
If we rewound time, many thousands of years when we were all cave people, what were our
daily stressors? Many people answer that a search for food would be a stressor; also, the fact that
we did not want to be food for other predators was another of our main stressors. As such, since
we did not want to be prey to these predators, our brains have evolved to notice and make
associations warn us of potentially dangerous situations or threats. For example, when we are
walking through the forest and see leaves ruffling in the distance, what is the first thought that
comes to mind? For many, the first thought is to wonder about what could be behind the bushesor trees as we have been conditioned to think this way. These kinds of thoughts and associations
are what has kept us safe and alive over the years.
If we saw a bear cross our path, our brain would see the bear and tell our body to react. The
reason we say our brain sees the bear and not our eyes is that our eyes are only receptors for
light. They send this information through our optic nerve to the occipital lobe of our brain, where
it is interpreted to tell us what we see. When our brain sees the threat, it’s putting us in a “Fight
or Flight” state. However, there is also a 3rd state that is often overlooked; we call this the
“Freeze” state. These states are activated by the release of adrenaline and cortisol in our system
from the sympathetic division of the autonomic nervous system.
The “Fight” mode is just as it sounds; we take a stance to face our threat and combat it, with our
bear example, it’s picking up a stick and fighting against the bear. The “Flight” mode is also just like it sounds; we want to escape or flee from the threat to a safer place. Here we run away from the bear to a safer place using the same example with our bear. The third and often overlooked state is “Freeze.” With this state, people mention they become so overwhelmed that they feel frozen in place and unable to move or react. An example of this is during natural disasters or significant accidents, people mention they want to help someone in need, but they were unable to move as they were so overwhelmed with emotions physically. Now that we know a bit more about what stress is, let’s fast forward to the present time. As we
don’t often see wild bears and predators on a daily basis, our sources of stress have changed.
However, why do we not continue to have the same reaction in front of the bear when we see
him at the zoo? People often say because they know they are in a safe place, but what tells them
they are in a safe place? At this moment and time, our rational mind is taking over. As humans, we like to think we are highly evolved and intelligent individuals; however, our minds function in three fundamental states; the reasonable mind, the emotional mind, and the wise mind.
The emotional mind is when someone’s feelings and emotions are controlling their thoughts and
behaviors. An example of this is when you have to communicate with someone outraged. How
does this situation typically go? Most people say it generally doesn’t go well. This is because of
their emotional state; the angry individual is currently unable to be rational; however, when
they’ve had time to calm down, they can have a much more rational conversation.
The rational mind can be viewed as the opposite of the emotional mind. Here a person will use
logic and reason to plan how they should act in a situation. An example of this would be the CEO
of a large company that needs to lay off 400 employees. At this time, he/she would need to stay
rational as being emotional would inhibit him/her from performing his/her duties at that time.The wise mind can be described as a balance between the two. People can recognize and
understand their emotions; however, they can respond to them more rationally. If we return to the
example of the bear at the zoo, our emotional mind and stress can quickly tell us that seeing a
bear equals danger and that the security measures that were put in place could fail at any
moment. We nevertheless can use our wise mind to calm ourselves down, as we know, that the
chances of the bear escaping its enclosure at present is highly improbable; this rational
counteraction to our stress calms us down.
As we do not see many predators in the wild anymore, what are now our daily stressors? Many
people answer money, work, family responsibilities, traffic and many other sources of stress. If
we use money, for example, money in itself should not be a source of stress as it is an arbitrary
value that humans have attributed to pieces of paper. However, when we think of a bill that needs
to be paid tomorrow, and we don’t have the funds in our account, we start to feel anxious. At this
moment, many people start to project themselves into the future and into different scenarios that
result from them not having the money to pay the bill (ex. being on the street begging for money,
the house being repossessed, having services shut down). This foresight capacity is excellent for
the advancement of humankind; however, it is also very detrimental to anxiety. While we like to
think that our brains are highly evolved, they still have rather primitive tendencies that were
learned to protect us, as such, when we imagine ourselves in these different scenarios, our brain
has not evolved to identify the difference between what we are seeing and the scenarios we are
imagining. Remember, the brain is what interprets the light that is captured by our eyes;
therefore, when we imagine a stressful situation, our brain is unable to differentiate between the
two. Our brain believes these scenarios to be real and will start to put our body into that
reactionary “Fight, Flight or Freeze” state, which produces all of the physical responses and
symptoms that we often associate with anxiety.
As we now understand that anxiety is our mind placing our body in survival mode due to a real or perceived threat, what are the different types of anxiety disorders?
Generalized anxiety disorder We talk about an excessive and uncontrollable worry about several everyday problems or occurrences which persists for more than 6 months and interferes with the ability to focus on
tasks. Phobias We talk about an intense and irrational fear of a specific thing. While many people have fears, a phobia tends to disrupt the person’s life and daily activities as they will actively seek to avoid
any situation which could potentially expose them to their feared object or situation.
Panic Disorder
With panic disorders, it involves panic attacks, which can happen in unexpected situations and
on a repeated basis. While a panic attack will be sudden and intense, it also happens for a short-period. People who suffer from panic attacks also fear to have more panic attacks, which can also
trigger a panic attack.
Agoraphobia
Someone who has agoraphobia has a fear of being in a situation where they can’t escape, which
can lead to panic attacks. As such, they tend to avoid public places or venturing from their
homes.
Social Anxiety Disorder
With a social anxiety disorder, people have an intense fear of being embarrassed or receiving
negative evolutions from others. As such, they often avoid social situations and can have
significant impacts on their daily functioning at work, at school and with relationships.